Salbutamol Ups Mortality in Early Acute Respiratory Distress Syndrome

(HealthDay News) - For patients with acute respiratory distress syndrome (ARDS), treatment with intravenous salbutamol in the early course of disease is associated with a significant increase in 28-day mortality, according to a study published online December 12 in The Lancet.

Fang Gao Smith, MD, from the University of Warwick in the United Kingdom, and colleagues investigated whether treatment with salbutamol in the early course of ARDS improved clinical outcomes. Between December 2006 and March 2010, 326 patients (≥16 years of age) who were intubated and mechanically ventilated within 72 hours of ARDS onset were randomly assigned to receive 15µg/kg ideal body weight/hour of salbutamol (n=162) or placebo (n=164) for up to seven days. Death within 28 days of randomization was the primary outcome; analysis was by intention-to-treat.

The investigators found that one patient in each group withdrew consent. Salbutamol treatment increased 28-day mortality compared with placebo treatment (34% and 23% of patients, respectively; risk ratio, 1.47). After the second interim analysis, recruitment was stopped due to safety concerns.

"Treatment with intravenous salbutamol early in the course of ARDS was poorly tolerated. Treatment is unlikely to be beneficial and could worsen outcome," the authors write.